Unspinning the Planned Parenthood Video

Several Republican presidential candidates have claimed that Planned Parenthood is “profiting” from abortions. But the full, unedited video they cite as evidence shows a Planned Parenthood executive repeatedly saying its clinics want to cover their costs, not make money, when donating fetal tissue from abortions for scientific research.

Four experts in the field of human tissue procurement told us the price range discussed in the video — $30 to $100 per patient — represents a reasonable fee. “There’s no way there’s a profit at that price,” said Sherilyn J. Sawyer, the director of Harvard University and Brigham and Women’s Hospital’s “biorepository.”

Republicans made their claims following the release of a secretly recorded video showing Deborah Nucatola, the senior director of medical services at Planned Parenthood, discussing the procurement of fetal tissues when conducting abortions. The edited video, released July 14 by an anti-abortion group called the Center for Medical Progress, leaves the impression that Nucatola is talking about Planned Parenthood affiliates making money from fetal tissue. But the edited video ignores other things Nucatola said that contradict that idea.

The Videos, Edited and Unedited

At one point in the unedited video (which was also released by the group), Nucatola says: “Affiliates are not looking to make money by doing this. They’re looking to serve their patients and just make it not impact their bottom line.”

Nucatola also says, “No one’s going to see this as a money making thing.” And at another point, she says, “Our goal, like I said, is to give patients the option without impacting our bottom line. The messaging is this should not be seen as a new revenue stream, because that’s not what it is.”

The footage was recorded secretly during a lunch meeting on July 25, 2014, between Nucatola and two people posing as employees of a company looking to procure fetal tissue for research purposes.

While eating a salad and drinking red wine, she casually discusses which tissues are valued by researchers and how to preserve those tissues while conducting abortions. Planned Parenthood President Cecile Richards has apologized for Nucatola’s “tone” and manner of speaking, which House Speaker John Boehner condemned as “cavalier” in calling for a congressional investigation.

In the edited video, Nucatola says the cost for fetal tissue specimens was between $30 and $100, “depending on the facility and what’s involved.” She defined “specimen” as, “one case. One patient.”

Republicans have focused on those comments, characterizing the practice as a way to profit off abortion:

Rick Perry, July 14: The video showing a Planned Parenthood employee selling the body parts of aborted children is a disturbing reminder of the organization’s penchant for profiting off the tragedy of a destroyed human life.

Carly Fiorina, July 14: This latest news is tragic and outrageous. This isn’t about “choice.” It’s about profiting on the death of the unborn while telling women it’s about empowerment.

Nucatola’s comment, though, isn’t evidence that Planned Parenthood or its affiliates are selling “body parts” or fetal tissue for profit. The full video shows that after Nucatola mentions the $30 to $100, she describes how those amounts would be reimbursement for expenses related to handling and transportation of the tissues. Nucatola talks about “space issues” and whether shipping would be involved.

We asked all three candidates listed above whether they believed the $30 to $100 per specimen amount constitutes making a “profit” from fetal tissue, and we did not receive specific answers to that question.The chief political strategist for Rand Paul’s campaign, Doug Stafford, sent us the following statement in an email:

Stafford, July 15: Planned Parenthood and their supporters in the media are willing to say anything to defend their taxpayer funded abortions and profiteering from selling aborted fetuses. They want to argue about what week they kill a child or how much they do or do not profit? What’s blatantly obvious is that Planned Parenthood is trying to distract from their extremist positions and immoral “business.”

We also asked experts in the use of human tissue for research about the potential for profit. Sherilyn J. Sawyer, the director of Harvard University and Brigham and Women’s Hospital’s “biorepository,” told us that “there’s no way there’s a profit at that price.” She continued in an email:

Sawyer, July 20: In reality, $30-100 probably constitutes a loss for [Planned Parenthood]. The costs associated with collection, processing, storage, and inventory and records management for specimens are very high. Most hospitals will provide tissue blocks from surgical procedures (ones no longer needed for clinical purposes, and without identity) for research, and cost recover for their time and effort in the range of $100-500 per case/block. In the realm of tissues for research $30-100 is completely reasonable and normal fee.

Jim Vaught, president of the International Society for Biological and Environmental Repositories and formerly the deputy director of the National Cancer Institute’s Office of Biorepositories and Biospecimen Research, told us in an email that “$30 to $100 per sample is a reasonable charge for clinical operations to recover their costs for providing tissue.” In fact, he said, the costs to a clinic are often much higher, but most operations that provide this kind of tissue have “no intention of fully recovering [their] costs, much less making a profit.”

Carolyn Compton, the chief medical and science officer of Arizona State University’s National Biomarkers Development Alliance and a former director of biorepositories and biospecimen research at the National Cancer Institute, agreed that this was “a modest price tag for cost recovery.” Compton told us in an email: ” ‘Profit’ is out of the question, in my mind. I would say that whoever opined about ‘profit’ knows very little about the effort and expense involved in providing human biospecimens for research purposes.”

Nucatola does make one statement in the unedited video that suggests to critics that some clinics would be comfortable with a payment that was slightly more than their expenses for providing the tissue. “I think for affiliates, at the end of the day, they’re a nonprofit, they just don’t want to — they want to break even. And if they can do a little better than break even, and do so in a way that seems reasonable, they’re happy to do that,” Nucatola says.

But immediately after this statement, Nucatola goes on to say: “Really their bottom line is, they want to break even. Every penny they save is just pennies they give to another patient. To provide a service the patient wouldn’t get.” Planned Parenthood told us that she may have been referring to more general operations of the clinics.

Nucatola repeatedly talks about affiliates only wanting to provide a service to their patients, who elect to donate the tissue for medical research, and not having that service impact their bottom lines. She says that it’s “not a new revenue stream the affiliates are looking at” and that “nobody should be ‘selling’ tissue. That’s just not the goal here.” She says some affiliates might donate the tissue for free.

Nucatola also discusses Planned Parenthood clinics’ interactions with a tissue procurement company called StemExpress. The company’s website says that partnering with StemExpress can be “financially profitable” for a clinic — a point that some conservativewebsites have singled out. But this also does not constitute evidence that Planned Parenthood is profiting in such a way.

StemExpress, which provides other types of tissue aside from fetal tissue, did not respond to our request for clarification on profitability. It did release a statement on its website expressing pride in its work to advance research and saying it complies “with all laws.”

According to another tissue procurement company called Advanced Bioscience Resources, which has provided fetal tissues to researchers in a number of federally funded studies, the costs mentioned in the video are reasonable. Linda Tracy, ABR’s president, told us in an email that “[i]t is difficult to pinpoint the exact cost of tissue acquisition due to the many variables involved,” such as the location of the facility, the specific requests from researchers and any special handling that is required. She said, however, that “$30 to $100 is within a comparable range of what ABR pays for reimbursement of costs.”

At one point in the video, Nucatola tells the “buyers” (the actors purporting to represent a fetal tissue procurement company are described as “buyers” in a transcript provided by the Center for Medical Progress) that affiliates wouldn’t make decisions about whether to work with a tissue research organization based on money. “You could call them up and say, ‘I’ll pay you double the money,’ and they’re almost more inclined to say no, because it’s going to look bad. … To them, this is not a service they should be making money from, it’s something they should be able to offer this to their patients, in a way that doesn’t impact them.”

She then suggests that these “buyers” might be able to compete with other companies by offering extra services, such as taking tissue the clinics would otherwise have to dispose of themselves.

In a statement on its website, Planned Parenthood defended its affiliates’ practice of fetal tissue donation as “standard across the medical field”:

Planned Parenthood, July 14: At several of our health centers, we help patients who want to donate tissue for scientific research, and we do this just like every other high-quality health care provider does — with full, appropriate consent from patients and under the highest ethical and legal standards. There is no financial benefit for tissue donation for either the patient or for Planned Parenthood. In some instances, actual costs, such as the cost to transport tissue to leading research centers, are reimbursed, which is standard across the medical field.

Richards, the Planned Parenthood president, said in a video response to the controversy: “The allegation that Planned Parenthood profits in any way from tissue donation is not true.”

On July 21, the Center for Medical Progress released a second, similar video, again featuring a discussion with a Planned Parenthood official in a restaurant. The numbers mentioned in the edited video are similar to what Nucatola said. The official, Mary Gatter, quotes a rate of $75 per specimen, and says she was thinking of saying $50. The discussion only reaches $100 because the “buyers” in the video mention higher prices. At one point, Gatter says that “we’re not in this for the money,” and later she reiterates that “money is not the important thing.”

Though few studies of costs associated with fetal tissue acquisition are available, existing evidence does suggest the prices named in the video are in line with general practices. The National Institutes of Health conducts research with fetal tissue, and in the late 1990s, the Government Accountability Office (then known as the General Accounting Office) looked into the acquisition of such tissue, finding that the direct cost to researchers was “low.” GAO said payments primarily went to “central tissue suppliers,” as opposed to health clinics. In most cases, GAO found that clinics did not charge researchers, but when they did, the cost ranged from $2 to $75. The report did not address how much clinics might have received from central tissue suppliers, which is more analogous to the situation presented in the video.

What Does the Law Say?

In a statement made to CNN, another presidential candidate, retired neurosurgeon Ben Carson, called the practice discussed in the video a “clear violation of federal law.” The “sale” of organs, both adult and fetal, for transplantation is indeed illegal, but donation of tissue — both from aborted fetuses and from adults — is not. And payment for “reasonable” costs is also allowed under the law.

The video itself highlights a portion of title 42 of the U.S. code, which reads: “It shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce.” The law does include fetal tissue in its definitions. It says that the term “valuable consideration” doesn’t include “reasonable payments” for removal, transportation, preservation and other associated costs.

In 1993, a law pertaining to federally funded NIH research was enacted that allows donation of fetal tissue from induced abortions if certain criteria are met. These include that the woman donating is not aware of the recipients of the tissue, and that the abortion timing, procedures or method itself would not be altered for the sole purpose of obtaining the tissue.

The 1993 law also says that it is unlawful “for any person to knowingly acquire, receive, or otherwise transfer any human fetal tissue for valuable consideration if the transfer affects interstate commerce.” The law again excludes the types of costs Nucatola discussed in the video: “The term ‘valuable consideration’ does not include reasonable payments associated with the transportation, implantation, processing, preservation, quality control, or storage of human fetal tissue.”

The American Medical Association echoes this in its ethical guidelines on the issue: “Fetal tissue is not provided in exchange for financial remuneration above that which is necessary to cover reasonable expenses.”

Why Is Fetal Tissue Scientifically Useful?

Historically, the use of fetal tissue has produced some groundbreaking scientific discoveries. According to the American Society for Cell Biology, a nonprofit representing a large and varied group of scientists, “Fetal cells hold unique promise for biomedical research due to their ability to rapidly divide, grow, and adapt to new environments. This makes fetal tissue research relevant to a wide variety of diseases and medical conditions.”

According to the Guttmacher Institute, a nonprofit focused on sexual and reproductive health, tissue from fetuses has been used since the 1930s for a variety of purposes. Perhaps most famously, the 1954 Nobel Prize in medicine was awarded to researchers who managed to grow polio vaccine in fetal kidney cell cultures.

In another example, Leonard Hayflick created a cell line from an aborted fetus in the early 1960s that has been used to create vaccines against measles, rubella, shingles and other diseases. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, told the journal Nature in 2013 that “[t]hese cells from one fetus have no doubt saved the lives of millions of people.”

In more recent years, however, the use of stem cells for therapeutic and research purposes has taken a more central role than fetal tissue. As Arthur Caplan, a bioethicist at New York University, told Buzzfeed News, “fetal cells are not a big deal in science anymore.”

In spite of the waning interest, it remains legal to donate tissue from a legally aborted fetus, and for that tissue to be used for research purposes.

Editor’s Note: SciCheck is made possible by a grant from the Stanton Foundation.